African American Women's Perceptions of Personal Risks for Heart Disease

161 Pages·2015·1.21 MB·English

Walden University
ScholarWorks
Walden Dissertations and Doctoral Studies
Walden Dissertations and Doctoral Studies
Collection
2014
African American Women's Perceptions of Personal
Risks for Heart Disease
Fecelia Laurice Holt
Walden University
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Walden University

College of Health Sciences

This is to certify that the doctoral dissertation by

Fecelia Holt

has been found to be complete and satisfactory in all respects,
and that any and all revisions required by
the review committee have been made.

Review Committee
Dr. Jacqueline Fraser, Committee Chairperson, Public Health Faculty
Dr. Bernice Kennedy, Committee Member, Public Health Faculty
Dr. David Stein, University Reviewer, Public Health Faculty

Chief Academic Officer
Eric Riedel, Ph.D.

Walden University
2014
Abstract
African American Women’s Perceptions of Personal Risks for Heart Disease
by
Fecelia L. Holt

MPH, Armstrong Atlantic State University, 2001
BS, Savannah State University, 1999

Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
College of Health Sciences

Walden University
November 2014
Abstract
Heart disease has been the primary cause of death among both men and women in the
United States. More African American women are developing and dying from heart
disease than any other ethnic group; yet, they are less likely than European American
women to know that they have the major risk factors for heart disease. The purpose of
this study was to determine the overall knowledge and health beliefs about heart disease
among African American women. Five health belief model constructs of perceived
susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to
action were applied as the theoretical framework for the study. Linear multiple
regression was used to analyze the association between participants’ (a) knowledge of
heart disease risk factors, (b) knowledge of heart attack symptoms, (c) perceptions of
personal risks for heart disease, and (d) demographic background and their awareness of
heart disease. Snowball sampling was used to recruit participants. E-mail, LinkedIn, and
Facebook invitations with the American Heart Association Women’s Health Study
Google doc was sent to all family, friends, and associates who met the criteria for
participation (N = 389). Results showed that the variables of African American women’s
knowledge of heart disease risk factors, perceptions of personal risks for heart disease,
age, and family history of heart disease were statistically associated with awareness of
heart disease. The positive social change implications include bringing more awareness
of heart disease to African American women and encouraging them to have heart health
dialogue with their friends and family.
African American Women’s Perceptions of Personal Risks for Heart Disease
by
Fecelia L. Holt

MPH, Armstrong Atlantic State University, 2001
BS, Savannah State University, 1999

Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
College of Health Sciences

Walden University
November 2014
Dedication
My dissertation is dedicated to the late LaSonya Stovall: advocate for college life,
big sister, friend, sorority sister, Godmother to my oldest daughter, and my comic relief
who died after having heart complications. She serves as my example of how we as
women, spend so much time caring, doing for others, and working hard that we
sometimes do not realize the clues our body gives us that we are overworking it. This
was a woman who lost several pounds, walked 4 miles a day religiously, watched what
she ate periodically, survivor of breast cancer, and yet she died… Let this dissertation
serve as an eye opener for ALL African American women that we must make a conscious
effort to listen to our bodies, educate ourselves on heart disease, and live a HEART
HEALTHY LIFESTYLE.
Acknowledgments
First, to God almighty who makes all things possible in my life. I thank you Lord
for guiding my thoughts and actions to complete your will in this dissertation.
I would like to thank my dissertation chair Dr. Jacquie Fraser, committee member
Dr. Bernice Kennedy, and University Reviewer Dr. David Stein for your support and
guidance. I am grateful for your professionalism and assistance throughout my
dissertation process. Dr. Fraser I am so thankful to have had you as my chairperson.
A special thank you to Dr. Debra Dwight for your undying support throughout my
dissertation process and preparing me for my oral defenses. I THANK YOU; I could not
have made it past my proposal phase without YOU.
To my parents, sister, brother in law, and family, thank you for your 100%
support being available whenever I called. Daddy and mama thank you for your moral
and ethical guidance, and leadership throughout my life has helped shape me into the
woman I am today. To Felicia, my twin, my mirror: Thank you for being my
accountability partner (in the wee hours of the night) throughout this process, I definitely
would not have made it to the end without your support, critique, and push.
Most of all to my HUSBAND, I thank God everyday for blessing me with such an
awesome partner in life. Your uplifting words, faith in my abilities, even your stern push
at times to bring out my potential has made it possible for me to complete my
dissertation. Ahmed, Trinity, Xaria, and Shia, you guys are my BIGGEST cheerleaders
and thank you all for allowing me to take time away from the family to spend on my
dissertation. Family time is back to normal!
Table of Contents
List of Tables ...................................................................................................................... vi
List of Figures .................................................................................................................... vii
Chapter 1: Introduction to the Study ................................................................................... 1
Background .................................................................................................................... 1
Problem Statement ......................................................................................................... 4
Nature of the Study ........................................................................................................ 5
Research Questions and Hypotheses ............................................................................. 7
Purpose of the Study ...................................................................................................... 9
Social Change .............................................................................................................. 10
Theoretical Base .......................................................................................................... 11
Operational Definitions ............................................................................................... 13
Assumptions ................................................................................................................ 14
Limitations ................................................................................................................... 15
Scope and Delimitations .............................................................................................. 15
Significance of the Study ............................................................................................. 16
Summary ...................................................................................................................... 17
Chapter 2: Literature Review ............................................................................................ 19
Introduction ................................................................................................................. 19
Heart Disease ............................................................................................................... 20
Risk Factors ........................................................................................................... 21
Smoking ................................................................................................................. 22
i
High Blood Pressure/High Blood Cholesterol ...................................................... 22
Diabetes ................................................................................................................. 24
Diet, Physical Activity, & Overweight .................................................................. 25
Awareness of Heart Disease Risk Factors ............................................................. 27
Heart Attack Symptoms ........................................................................................ 30
Awareness of Heart Attack Symptoms .................................................................. 31
Perceptions of Heart Disease ....................................................................................... 32
Heart Disease Awareness ...................................................................................... 32
Perceived Risk for heart disease ............................................................................ 38
Health Belief Model .................................................................................................... 42
Gap in Research ........................................................................................................... 44
Summary ...................................................................................................................... 45
Chapter 3: Research Method ............................................................................................. 47
Introduction ................................................................................................................. 47
Research Design and Rationale ................................................................................... 47
Setting and Sample ...................................................................................................... 49
Instrumentation and Materials ..................................................................................... 50
Data Collection ............................................................................................................ 52
Data Analysis ............................................................................................................... 53
Research Question 1 .............................................................................................. 55
Research Question 2 .............................................................................................. 56
Research Question 3 .............................................................................................. 56
ii
Research Question 4 .............................................................................................. 56
Threats to Validity ....................................................................................................... 57
Protection of Human Participants ................................................................................ 57
Summary ...................................................................................................................... 58
Chapter 4: Data Analysis ................................................................................................... 60
Introduction ................................................................................................................. 60
Data Collection ............................................................................................................ 61
Descriptive Data of Participants .................................................................................. 62
Results of Knowledge, Perceptions, and Awareness of Heart Disease ....................... 65
Knowledge of Heart Disease Risk Factors ............................................................ 65
Knowledge of Heart Attack Symptoms ................................................................. 66
Perceptions of Personal Risk for Heart Disease .................................................... 67
Awareness of Heart Disease .................................................................................. 68
Health Belief Model Constructs .................................................................................. 69
Perceived Susceptibility ........................................................................................ 69
Perceived Severity ................................................................................................. 70
Perceived Benefits ................................................................................................. 71
Perceived Barriers ................................................................................................. 72
Cues to Action ....................................................................................................... 73
Statistical Testing of Hypotheses ................................................................................ 74
Correlation Analyses: Pearson R ........................................................................... 75
Research Question 1 .............................................................................................. 77
iii